An estimated 80% of Americans will experience back pain at some point during their lives. This may seem like a staggering number, but it’s actually not too surprising when you consider the incredible amount of pressure and strain that’s exerted on the spine every single day.

There are some forces, like gravity, that are beyond our control and will put strain on our spines whether we like it or not. However, there are certain lifestyle habits that we can change or adopt to help ensure that our backs are as happy and healthy as possible.

Now it’s important for us to note that most back pain is caused by tension, strain or inflammation in the muscles, joints and tendons that support the spine and we are assuming this as the cause of your occasional pain. However, this isn’t always the case. Daily, severe back pain is not normal and probably symptomatic of a more serious issue. If this sounds like you, we recommend that you get in touch with your spinal specialist and get it checked out.

Below we’ve compiled some of the surprising, common habits that can actually cause back pain. The good news is that all of these habits can be changed, which means that you don’t have to suffer needlessly from lifestyle-induced pain.

1. You’re consistently stressed

Stress is a very common, natural response to demands, fear or danger that most, if not all, people experience hundreds of times throughout their lives. Stress in and of itself isn’t a bad thing. As a matter of fact, some studies have shown that limited amounts of stress can actually be good for us, making us better equipped to fight other areas of discomfort in our lives.

However, science agrees that too much, or chronic, stress is toxic to the mind, body and soul. People tend to carry their stress differently. For some, it controls their thoughts and denies them the ability to work or focus on anything. For others, it manifests itself emotionally, causing depression, anger or high amounts of anxiety. And still others find that their stress is carried in their bodies, causing tension, stiff muscles and even inflammation.

The spine is supported by hundreds of different muscles throughout the back, shoulders and neck. When you’re stressed these muscles naturally begin to tighten, especially in your neck, shoulders and lower back; this is why many people who are stressed complain about having “knots” in their backs. When this occurs, these tight or strained muscles can start pulling on spinal structures which not only affects the stability of the back, but also causes pain that feels like it’s emanating from your spine. It’s also important to note that anxiety can cause what is known as a pain cycle. You have back pain, so you begin to worry about it which, in turn, causes you more anxiety and leads to more back pain.

So how do you fight stress that’s causing back pain?

First, you need to realize that there are always going to be stressful situations in life and you won’t be able to cut them out entirely. Therefore the key is to set yourself up for success by avoiding instances that could become stressful and develop your response to situations that do occur to help you navigate them more smoothly.

For example, if you find that you get frustrated by sitting in traffic, think about ways to make your commute more enjoyable and take your mind off the potentially stressful situation around you. Try listening to calming music, call a friend or family member, listen to a podcast or purchase an audiobook you’ve been wanting to read. Simple steps will help eliminate stress and protect your spine health.

2. You have an unhealthy diet

Diet is one of the key factors that affects our spinal health. Eating unhealthy meals that are high in processed sugar or fat can cause inflammation in your spine and the muscles supporting it, leading to potentially significant amounts of back pain.

Additionally, a poor diet can cause unhealthy weight gain. While, to date, there haven’t been any thorough studies defining the link between obesity specifically causing spinal conditions, there is an undeniable connection between it and back pain. For example, it is known for a fact that people who are physically obese are more likely to suffer from strained muscles and joint pain which can cause back pain than people who maintain a healthy weight.

The problem with obesity is the amount of extra pressure it places on the spine and the supporting structures. Our spines are built to bear weight and withstand the constant pressure that is exerted on them throughout an average day. The discs that separate your vertebrae are filled with a gelatinous substance that does a great job at providing shock absorption for a healthy individual. However, when extra weight is added to the equation, it can put excessive strain on the discs within the spine and cause them to lose water more quickly. When the gelatinous substance within each disc is no longer providing shock absorption, all the weight and pressure is being placed entirely on the rigid outer shell. While this isn’t necessarily a problem every once in a while, consistent pressure can cause the annulus to weaken, collapse or break which often leads to premature degenerative disc disease or a herniated disc.

Additionally, eating foods that are high in processed sugars and/or fats puts you on the fast-track to inflammation. The issue with these foods is that they increase cortisol levels within the body. Cortisol is, in moderation, good for the body and serves multiple beneficial purposes. However, when there’s an excess amount circulating through the body, it typically causes inflammation in connective tissues which can lead to back pain.

Cleaning up your diet is the best way to help you avoid inflammation and fight excess fat throughout your body. Most doctors recommend that you start by trying to cut out processed foods from your diet including products containing enriched white flour (white bread, pasta, crackers, cookies, donuts and other pastries), soda and other artificially flavored or sweetened drinks, processed cheese, alcohol, caffeinated coffee and/or tea.

Depending on your current diet, this may seem like a lot of change, so try cutting out these items for three weeks, then evaluate and see if it has helped you feel better.

3. You wear high heels consistently

Here’s just another reason to save the high heels for special occasions only, ladies.

Turns out, studies have shown that back problems are very common in people who wear high heels frequently.

The problem stems from fact that heels put an excessive amount of pressure on the balls of your feet; up to 76% more for heels longer than three inches. This leads to the foot pain that women commonly complain of when they’re wearing high heels, but it doesn’t stop there. In fact, this pressure typically travels up the legs and puts extra pressure on the knees, the pelvis and the muscles in the lower back.

In the short term, the pressure and awkward position of your feet causes your back to arch and forces your upper body to lean back in order to maintain your balance. This means that your lumbar muscles need to work harder to support your spine for an extended amount of time; which can lead to muscle spasms, strains or back pain in general.

For people who wear heels consistently, the damage can be much more nefarious and actually cause anatomical changes to your body including thickened ligaments and shortened muscles in the legs and lower back.

Don’t get us wrong, in moderation there’s no problem with wearing high heels that aren’t too tall, properly fit and don’t crush your toes. The real issues arise when you wear them consistently or for long periods of time.

If this sounds like you, we recommend swapping out your high heels for something stylish, but also comfortable and provide good arch support for your feet and take pressure off the muscles in your back.

4. You have bad posture

Over 80% of working Americans spend their days working at some form of desk job. Not only has this uptick in white collar work made sedentary lifestyle a common occurrence across the nation, but also has made it incredibly easy for most people to consistently have bad posture.

It’s easy to slump or curve your neck when you’re looking at a computer and, honestly, you may not even notice any difference in your back after doing it for a few hours. However, over time, bad posture can start putting unnecessary stress on the structures supporting your neck and/or lower back which can lead to pain. Additionally, if you maintain a bad posture for long enough, you can actually start changing your spinal anatomy and causing premature spinal degeneration, which can lead to problems further down the road.

The best way to combat bad posture is to take the advice of your mother and sit up straight! Making a concerted effort to keep your back straight while you’re sitting helps keep your muscles and spine where they were meant to be and helps avoid unnecessary strain on any particular part of your spine.

Another great way to help your posture is to stand up for a couple of minutes for every hour that you’re sitting. When you stand, try to stretch out the muscles in your neck, back and legs. This will help keep these structures from pulling on your spine, encourage blood flow to your muscles, joints and tendons and, also, help keep your spinal discs well-hydrated.

Most people want to have a better posture when they’re sitting, but many simply forget to sit up straight or stand every once in a while. If this sounds like you, consider setting reminders for yourself in the form of sticky notes, calendar reminders or to-do list tasks. If even that is too much, you can always consider purchasing a device that reminds you to sit up straight every time it notices your slouching.

5. You’re sleeping on an old mattress

The average person spends nearly 230,000 hours of their lives sleeping. That’s a significant amount of time and spending it on an old, cheap or incorrect mattress can not only impact your quality of sleep, but actually cause serious damage to your spine.

Following “conventional wisdom” or even doctor recommendations, people who struggle with back pain typically purchase the firmest mattress they can find in order to keep their spine aligned throughout the night. The truth is that there’s actually very little evidence to support this line of thinking and a survey of nearly 300 people who slept on an orthopedic (very firm) mattress found that they experienced very poor sleep quality.

Here’s the twist though—super soft mattresses aren’t any better. While they may offer your back and joints some support when you first lay down, they can cause your joints to bend or twist improperly as you sink into it throughout the night.

So what are you supposed to do? Well, you need to understand that there is no mattress that is universally best for treating back pain. On the contrary, the biggest factor that should play into your mattress purchase decision is personal preference. What feels best for you? What allows you to wake up feeling rested and pain-free? Then that’s the mattress you should go with.

That said, there are some things that you should be looking for when you go mattress shopping. First, know yourself and your sleeping habits. Do you sleep on your side? Your stomach? Your back? Do you typically toss and turn while you sleep? Do you get easily hot or cold during the night? Being able to answer these questions will help you find a mattress that caters to your individual needs and provides you with consistent support throughout the night.

Second, know what your mattress is supposed to do. Sleep is meant to be restorative and gives the muscles and joints that support the spine a much-needed time to recover and heal from the wear and tear of the previous day. Your mattress needs to provide you with enough support to keep your spine aligned naturally. Otherwise, these your spinal structures will be forced to continue to work throughout the night which means that you’re setting yourself up for stiffness, soreness and pain the next morning.

Finally, try out different mattresses. Look, mattresses are expensive, especially the ones that claim to offer the best spine support. It’s a big purchase decision and not only financially but also considering the fact that you’re going to spend potentially years of your life sleeping on it. So don’t be afraid to try out a couple different options before settling on the mattress that’s perfect for you. Just note, it can be difficult to test out mattresses in store. What feels good for a couple of minutes may not be right for you during an entire night.

That’s why we recommend that you try out your mattresses at home for a couple weeks to see how it works for you. Many online mattress companies like Casper, Purple, Tuft and Needle, Sleep Number and others will allow you to try out their mattress risk-free for 100 days, so definitely take advantage of that.

6. Spending too much time looking down at your phone

A recent study found that 79% of the population between 18 and 44 have their mobile devices with them all the time. While cell phones have allowed us to stay incredibly connected with the world around us, they could also be causing us some pretty serious health issues.

One of the most prevalent issues we’ve seen rising over the past couple of years is a condition that’s being called, “Text neck”. Essentially, text neck describes the damage or pain that can arise from frequently looking down at your phone for extended periods of time. Don’t spend a lot of time looking at your phone? Well text neck can also affect people who spend their days looking down at computer screens, reading books, writing and more.

The problem with looking down for extended periods of time is that the muscles and tendons surrounding your spine have to exert a lot of effort to keep your head suspended in that position. The head of an average adult weighs about 11 pounds and this weight can really become strenuous over time.

To get a better idea of how much weight the muscles and tendons in your back carry when you’re looking down, grab two 5 pound bags of flour or sugar, hold them suspended in one hand and see how long you can last.

Now you can see how, over time, looking down with all this weight can cause muscle strain, tension, thickening of ligaments and even, some studies suggest, chronic problems in the neck like arthritis.

The best way to avoid text neck is to, you guessed it, not spend so much time looking down at your phone, book or laptop! When possible, try to keep these things at or around eye level.

There are plenty of handy tools to help available to help you keep yourself from slouching. For people that work desk jobs and spend most of their days working on a computer, consider buying a standing desk or purchasing a computer stand that sets your computer at eye level.

If that isn’t possible, then just remind yourself to take stand up every hour for a couple minutes to stretch out and give your neck muscles a much-needed break.

7. You smoke

It’s common knowledge that smoking is detrimental to your lung and heart health, but people are often surprised to hear that it can also play a significant role in back pain. Studies have found that nicotine, the addictive chemical in cigarettes, actually restricts blood flow to spinal structures; specifically your spinal discs.

As we’ve mentioned before, your discs are vital to providing your spine with shock-absorption and need proper blood flow in order to ensure properly they are receiving key nutrients to help them rehydrate, heal and remain strong enough to keep your vertebrae separated. Over time, however, these discs naturally begin to degenerate due to the constant wear and tear they endure on a daily basis. Clinically, this process is known as Degenerative Disc Disease and it occurs in just about everyone as they age.

Other studies have found that smoking restricts the amount of calcium that is absorbed into the body. This can have some dangerous side effects including decreased bone density, slower healing after bone fractures and even osteoporosis; all of which can contribute to chronic back pain.

Research from the CDC shows that nearly 7 out of every 10 people want to stop smoking completely. That’s a good thing! However, problems typically start to arise when people begin to fight their dependence on nicotine. The good news is that our knowledge of the addiction has grown and allowed us to develop some incredibly effective methods of treating it.

If you want to stop smoking, start by getting in touch with your primary care physician and ask them for their recommendation. Based on your health, personality and other characteristics, they will offer some recommendations for you on how you can best address your addiction and set you up for success.

8. You’re not exercising

Exercise is absolutely essential to ensuring health at all stages of life, but it becomes especially important as our bodies begin to age. Exercise is powerful for three reasons:

First, it is one of the few ways that we’re able to strengthen the muscles and other structures that support the spine. Oftentimes, we experience back pain due to muscle strain, tightness, inflammation or other form of injury. While these issues can’t always be avoided, an active lifestyle undeniably helps ensure they don’t occur as often or as severely.

Second, exercising allows blood to flow into key muscles and structures throughout the back, helping deliver key nutrients and promote healing to areas that are inflamed or prone to injury.

Finally, exercising helps keep your weight at bay. As we discussed earlier, this means that you’ll have less unnecessary pressure on your spine and, as a result, you’ll be more mobile and experience less pain.

It’s important for us to note that the type of exercise you choose to address your back pain is just as important as exercise in and of itself. For people who already struggle with back pain, we recommend low-impact exercises like swimming, biking, walking and yoga. These will provide you with all the benefits of exercise without exposing you to the potential injuries that come with higher-impact workouts like running.

That said, if you’re struggling with back pain, we recommend that you talk to your spinal specialist before starting any form of exercise. They will be able to identify the issue that’s causing you pain and let you know which exercises will be best to treat it and avoid further injury.

In conclusion, adjusting your lifestyle and being intentional about protecting your back can not only help you avoid pain in the short term, but it also gives you a much better chance at having a spine that ages healthily.

Once again, we want to remind you that daily back pain is not normal. If you are experiencing frequent spine or nerve pain, please schedule a consultation with your spinal specialist immediately.